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Guest Viewpoint: The Dementia Puzzle

Reaching for a dignified old age for all

Deepak Jobanputra of VitalityLife | 21st May 2019

Dementia is not an inevitable
factor in ageing. A welcome announcement last week from the World Health
Organisation (WHO) and a conclusion arrived at after a comprehensive review of
existing evidence. Instead, said the WHO, lifestyle factors, such as
inactivity, smoking, poor diet and alcohol consumption are significantly
increasing the chances of people getting dementia.

With the announcement coming
just a week before Dementia Action Week (May 20 to 26), it represents a timely
reminder of what we can all do as individuals to reduce the risk of getting
this life changing condition.

With 850,000 people now living
with dementia in the UK*, and this is set to rise further, prevention has got
to be something we all take seriously. We can’t just give in to this disease. Yet,
we’re also faced with the fact that as a nation we are more inactive than ever
before.

Last year Vitality
published a study that sought to understand how we could incentivise
people to live fitter and healthier lives. Performed in association with Apple
and RAND, it found that people who engage with Vitality’s Apple Watch benefit
saw an average 34% sustained increase in activity: 4.8 extra days of activity
per month. This activity increased across the full spectrum of Vitality
participants, regardless of health status, age or gender. In short, effective
use of wearables to incentivise behaviour change can lead to greater control of
health and wellbeing, encouraging people to become more active, and effectively
shifting the focus on to preventative care. The significance for individuals,
the insurance industry and wider society with regards to prevention against
many conditions – including dementia – is profound.

But, prevention is just part
of this dementia puzzle. One of the worst aspects of the condition is the ripple
effect it has. It’s not only the person diagnosed that’s affected, but their
families too. It’s often the family, certainly to start with, that picks up
care for their loved one.

What happens when that person
has no family who can take on this task, or they go on to need more extensive
care – either at home or in some form of residential care – continues to be a
well fought out argument in political circles. Given the pressure on both the
NHS and social care, we have arguably long since reached the point where we can
simply hope that the state will pick up this bill.

In advance of the social care
green paper, expected any time from the government, the Rt Hon Damian Green MP published
a paper (Centre for
Policy Studies, 2019) earlier this month looking at funding models
in more detail and asking what solutions could secure the future of care for
someone with dementia. The ultimate goal? To give everyone a dignified old age
no matter their economic circumstance or health condition.

A worthy aspiration. Green
puts forward a number of suggestions for funding this care, including a
taxation model, equity release, saving for the possibility that you may get the
condition. And he also looks to insurance to provide other solutions.

The difficulty with most of
these solutions is that they involve asking people to contribute to something
they may never get. Whilst we may be able to – and should – use activity and
other preventative measures to lower our risk, other factors inevitably play a
part. There is no certainty of who will – and will not – go on to get the
disease. So, prevention has to be balanced with protection.

In
line with this, any solution – from government or insurers – must consider the
realities of life. We’re all guilty of looking to the short term and who can
blame us – certain life stage priorities, such as buying a house or raising a
family, are all consuming. There’s no time, space or inclination to consider
the prospect of a potential future dementia diagnosis. Whilst most people
realise that early onset, or working age dementia does happen, dementia itself is
mostly associated as an older person’s disease. It’s back of mind, if there at
all.

Last
year, in a world first, Vitality took one step forward in this area, updating
its serious illness cover to reflect this growing need in society, providing
people with the cover they need in line with life stage priorities, plus an
instant pay-out for a number of conditions often associated with old age,
including dementia. This has the potential to make the world of difference to a
family that has someone diagnosed with the condition. And it’s been hugely
popular, with about two thirds of people opting to include it within their insurance.
Where insurance as a whole goes next will largely depend on what the
forthcoming Green Paper includes and how long it takes whatever it includes to
implement.

What is certain is that the
need is here now. And we need to all work together to find a solution. Around a
million people in the UK will have dementia by 2025, rising to two million by 2050[1]. As a result, it is
predicted to cost the UK a staggering £66bn by the same date[2] – over half the entire
current NHS budget, meaning the country will also need about 1.7 million
informal carers by that time, more than twice the estimated amount of people
currently providing care[3]. These are numbers which
should have us all looking for solutions, and quickly.